Jacqueline Mthembu

Impact of HIV testing on sexual health communication in South Africa

Objectives The South African government recently launched a national campaign to test 15 million South Africans for HIV by 2011. Little is known about how receipt of HIV testing might influence interpersonal communication. To explore these questions, the authors examined the effects of prior HIV testing on sexual health communication among South Africans. Methods Adults (N=1284; 98% black, 36% women, mean age 31) residing in a South African township completed street-intercept surveys. Results Of the 1284 participants, 811 (63%) had been tested for HIV. Among those who had been tested, 77% tested negative, 12% tested positive, and 11% did not know their test result or refused to answer. Compared with those who had not been tested, participants who had been tested for HIV were more likely to communicate with community members about (a) HIV/AIDS, (b) getting tested for HIV, and (c) using condoms. Testing positive for HIV was associated with communication with sexual partners about condom use. Among participants who had been tested for HIV, exploratory analyses revealed that those who had engaged in sexual health communication with community members or sexual partners reported more condom-protected sex than those who had not engaged in sexual health communication. Conclusions HIV testing is associated with sexual health communication among South African community members and sexual partners. Offering HIV testing to all South Africans may increase communication and lead to reductions in sexual risk.

Does perceived life stress mediate the association between HIV status and alcohol use? Evidence from adults living in Cape Town, South Africa

South Africa has the highest prevalence of HIV in the world. Because living with HIV is stressful and because alcohol consumption is often used to cope with stress, we examined whether stress mediates the association between HIV status and alcohol use among adults residing in South African townships. Field workers approached pedestrians or patrons of informal alcohol-serving venues (i.e., shebeens) and invited their participation in a survey. Of the 1717 participants (98% Black, 34% women, mean age = 31 years), 82% were HIV-negative, 9% were HIV-positive, and 9% did not know their test result. Participants living with HIV reported greater perceived life stress compared to participants whose HIV status was negative or unknown. Perceived stress was associated with an increase in the frequency of alcohol use (drinking days, intoxication, and drinking in shebeens/taverns). Subsequent analyses showed that stress mediated the association between HIV status and alcohol use. These findings indicate that greater frequency of drinking days, perceived intoxication, and drinking at shebeens was associated with elevated stress levels among participants who were HIV positive. Perceived life stress mediates the association between HIV status and alcohol use. Programs to enhance stress management among HIV-positive South Africans may help to reduce alcohol consumption, which may, in turn, lead to reduced rates of HIV transmission.

Intimate partner violence as a factor associated with risky sexual behaviours and alcohol misuse amongst men in South Africa

ABSTRACT Globally intimate partner violence (IPV) is a public health problem that can be perpetrated by both males and females, although males are more likely to inflict severe IPV-related injuries on their female partners. In low- and middle-income countries like South Africa, few studies have conducted research to determine whether IPV perpetration by men may be a risk factor for engaging in other risk behaviours. The aim of this study is to determine whether IPV perpetration by men is a risk factor for engaging in other risk behaviours with a particular focus on risky sexual behaviours and alcohol misuse. The data for this study were drawn from a multilevel intervention study, which addressed the nexus of alcohol abuse and HIV prevention among men in South Africa. Men were screened and recruited from informal drinking places within 12 communities situated in one of the oldest, predominantly Xhosa-speaking African townships in Cape Town. Univariate and multivariate logistic regression models were used to analyse the associations between IVP and potential explanatory variables. Of the 975 men included in the survey, 39.9% reported to have been involved in Intimate Partner Violence. IPV perpetration was significantly more likely among men who reported having a child [OR 1.51 (1.07–2.14) p = .019], having a casual sexual partner [OR 1.51 (1.11–2.05) p = .008], and those with possible alcohol dependence [OR 3.46 (1.17–10.20) p = .024]. IPV was significantly less likely among men with matric educational qualification than those with no education [OR 0.30 (95% CI: 0.09–1.02) p = .053] and among those who reported using a condom at last sex [OR 0.69 (0.50–0.97) p = .034]. We therefore recommend that interventions aimed at reducing IPV need to address risky sexual and drinking behaviours amongst men simultaneously, while also focusing on intimate relationship power dynamics and gendered norms amongst couples.

Prevalence of psychological distress and its association with socio-demographic and HIV-risk factors in South Africa: Findings of the 2012 HIV prevalence, incidence and behaviour survey

Background In South Africa, there are limited nationally representative data on the prevalence and factors associated with psychological distress. This study used a 2012 nationally representative population-based household survey to investigate factors associated with psychological distress in South Africa. Methods The survey is based on a multistage stratified cross-sectional design. Univariate and multivariate logistic regression models were fitted to identify factors associated with psychological distress. Results Out of a total 25860 participants, 23.9% reported psychological distress. Higher likelihood of reporting psychological distress was significantly associated with being female [OR = 1.68 (95% CI: 1.34–2.10), p < 0.001], aged 25 to 49 years [OR = 1.35 (95% CI: 1.08–1.70), p = 0.010] and 50 years and older [OR = 1.44 (95% CI: 1.06–1.97), p = 0.023)], Black Africans [OR = 1.61 (95% CI: 1.24–2.10), p < 0.001)], a high risk drinker [OR = 1.37 (95% CI: 1.02–1.83), p = 0.037], a hazardous drinker [OR = 4.76 (95% CI: 2.69–8.42), p < 0.001] and HIV positive, [OR = 1.79 (95% CI:1.55–2.08) p < 0.001], while lower likelihood of reporting psychological distress was significantly associated with being married [OR = 0.78 (95% CI: 0.62–0.98), p = 0.031), employed [OR = 0.71 (95% CI: 0.57–0.88), p = 0.002], and living in a rural formal area [OR = 0.73 (95% CI: 0.55–0.97), p = 0.033]. Conclusion There is a need to develop strategies to alleviate psychological distress in the general population, with a particular focus on those who may be more vulnerable to distress such as females, the aged, excessive alcohol users, the unemployed, people living with HIV and those residing in urban areas as identified in the current findings.

“I forgive him. It wasn’t easy for him”: social representations of perpetrators of intimate partner violence in the Western Cape Province media

ABSTRACT Over the last two decades, international scholars have studied representations of intimate partner violence against women in news media reports. Although these studies contributed to current understandings of how such violence is constructed in the media, few studies have specifically examined how perpetrators are represented in newspaper reports. The present study draws on social representations theory to interrogate how perpetrators of IPV are constructed in the print news media of the Western Cape Province. An inductive thematic analysis was conducted on 21 articles reporting men’s perpetration of violence against their female partners between the periods of September 2012 and February 2013. The findings revealed perpetrators were mainly represented as pathological, victims of an unjust justice system and characters readers could possibly sympathize with, which obscured their responsibility for the act(s) of violence. The article discusses implications of these representations in the context of violence against women in South Africa and how they resonate with current research internationally.